Fractured lateral malleolus

[hedgeofthehog]

Hello,
I fractured my left lateral malleolus almost 5 weeks ago. The fracture is at the tip, and the tip is still attached, I jumped over a fence landing on a rock and my ankle twisted and I was told the ligament attached to the tip is so strong that is what causes the fracture. I have had a non-weightbearing cast on since then and am due for a review on the 18th Sept when I hope to get the cast removed. Can you tell me do these types of fractures heal well as I am a big skier and want to be able to ski sometime in December and also what kind of physiotherapy will I need to get back on my feet? Will I be able to walk as soon as the cast comes off or not??
Many thanks,
Nigel

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[yelufem]

Hi dbcross.the diagnosis by the first doc could have been influenced by the situation that surrounded the case ,vis-a-vis the facility available and the history u gave to the doc.Nevertheless the doc shld hv probed further by sending u for a plain x-ray to rule out a fracture.Yes ur persistent pain could be secondary to early weight bearing even with the caste and not b/c of the seriousness of the fracture.It seems u didn't hv a comprehensive physio b/4 told by your doc to start bearing weight.This could retard fracture healing and triger inflammation .Also bad gait pattern which u could hv adopted to prevent pain may be reponsible for problem emernating from the other limb.I suggest u convince ur doc to refer ur case to a physiotherapist to co-manage the case with him.I wish to see u out of pain soon.Merry Xmas.yelufem,BMR(PT).

[gcoe]

Hi dbcross

This all sounds quite concerning. Did the orthopedic surgeon re X-ray your foot before deciding to keep you in a cast ie what was the reason for the decision. As for the other foot getting sore -2 things come to mind

1. You have been walking badly on your other foot. I take it you are using crutches - have you been shown how ton use them properly? This could be some sort of overuse problem from favoring the other leg

2. You could be having some sort of reaction. There is an unpleasant problem called complex regional pain syndrome and although it is not that common it could account for both the reason the pain has turned constant in theinjurd foot and the burning pain on the unaffected foot.

It could also just be that you are getting aches and pains from being immobilized and can't participate in your usual activities -that can happen too. If you are anxious and miserable about your situation pain can be amplified. However from what you have said something doesn't sound right. For your own peace of mind I would persevere and get it checked out -the state of the stress fracture ( it should be settling by now) and the reason for the burning pain in the other foot.

[akshatk7]

Sir, I fractured my lateral malleolus day before yesterday, i have been advised to wear a slab for a week which will be replaced by a fiber plaster.
My bone is barely out of place with a crack, tip still in contact with bone.
When will i be able to put weight on this and when it will heal?
My entire ankle pains when i touch it, is it normal given the fact a broke it day before?

[alophysio]

Hi akshatk7,

please follow the advice of your doctors. You might be in a slab for a week to allow swelling to be controlled. We cannot tell the type of fracture nor the severity so things will be a guess.

I am sure you will be fine in 6-8 weeks which is the general guideline i give for lower limb fractures.

Oh, BTW, a fracture hurts when you touch it. It is broken. It will heal. It will get better.

THanks

[akshatk7]

Thanks a lot,
I know a fracture is supposed to hurt, but what abt the area around it? It also hurts only when i touch, and when i am given a fiber cast, then will i be able to walk short distances?
And my doc is removing the slab on 1st August, tht is 4 days, not a week, is that OK?

[alophysio]

Yes it is ok to remove slab after 4 days (usually - depends on swelling) - sometimes i cast the next day after a fracture but you have to make sure the swelling is stable (won't increase) or they aren't too swollen - then the cast will become loose. You will be fine - this is such a normal fracture by the sounds of it

[akshatk7]

And after wearing the cast, will i be able to walk short distances?
Here's the x-ray.

DSC04036.JPG

[alophysio]

Hi - please understand that we cannot give specific advice. There are many factors that go into providing the correct advice for someone.

Your fracture doesn't look that bad and you should be able to walk with it BUT you must trust the people who are seeing you.

My advice is to listen to the doctors and professionals who are treating you. They have the best chance to give you good advice because they can see you in person.

Is there some reason you have doubts about your management?

[sethwood]

I fractured my right lateral malleolus playing football 11 days ago. It was classified as a Weber C and I had ORIF on it 4 days ago - 6 screws and a plate in my leg. I was originally told that I was going to be 12 weeks out before being able to play football again, but in the surgery they decided that my ligament was unstable and put a screw joining my fibia and tibia together. They now think I will be 18 weeks. 6 weeks in a cast, 2 weeks of partial weightbearing, the screw stabilising my ligaments removed at 8-10 weeks, then 8-10 weeks of physio. I just wondered if someone could give me feedback regarding when I will be able to start walking/running again and when Ill be able to return to training for football as Im getting pretty nervous about it! Im young, fit and healthy (good diet, dont smoke or drink) so was wondering if the 18 week timeframe is realistic seeing as everyone Ive spoke to with similar injuries has been out for 6-8 months!

[walker]

Thank you for making this site and member actively is robust.

52 yr male, good shape. I rolled my ankle and have a fractured lateral malleolus, the "tip" is broken clean through horizontal with "no" movement. Doc wanted boot but too painful to put on. Weight bearing cast for 10 days (Doc said I talked him into "over-treatment"). Cast off yesterday, x-ray shows no movement of bone, soft tissue supposedly healed, yet no bone healing yet. CAM Boot now goes on fine and works great but fracture still hurts like &%$#. Starting physio next week, range of motion, strength, etc. Until then R.I.C.E., boot and twice a day "point toe, do the alphabet". I take 6 advil a day, three in morning, three at night (otherwise too much discomfort). Though sleeping is difficult, any movement under covers wakes me up, I might wear boot to bed. I'd like to drop the advil and push through the discomfort. I'd like the drop the boot and push through. I'd like to start walking 10, 20, 30 minutes or more. Any thoughts? thx. cheers.

[alophysio]

hi walker and sethwood,

Sorry for late replies.

Sethwood, would need more info if you want more specific advice.

Walker, I want to know why you are in so much pain to be honest. In the boot, it should be feeling ok. Any more info?

Thanks

[walker]

hi walker and sethwood,

Sorry for late replies.

Sethwood, would need more info if you want more specific advice.

Walker, I want to know why you are in so much pain to be honest. In the boot, it should be feeling ok. Any more info?

Thanks

Sorry I wasn't clear. The day after I broke it I could not put on the boot because it was too tight. Touching or pushing the spot where the break is was torture. The swelling has gone down. Cast is off. Now walking around with and without boot (outside only with boot on). Start physio tomorrow, strength, ROM, mobility. R.I.C.E ah-roni as often as I can. By the way the Breg Polorcare 300 with ankle pad is awesome!

Again, thanks to this site I was calmed down about my break. I'm still not clear how the tip will reattach back to the fibula. Also, it seems it will be quite sometime before I can march around and go hiking.

[alophysio]

Hi Walker - no worries. The gap between the tip and the bone will come together with tissue you cannot see (well, maybe barely see) and it will fill in the gaps.Just because there is a gap on XRay doesn't mean there is nothing there, just nothing dense enough to show on XRay. I am going to guess (without knowing enough of your story so don't base your hopes on what i say!!) that you will be hiking and walking within 4-6 weeks of good rehab, maybe even sooner. If you go too hard, it can hurt for a lot longer so be patient Suck it up when the physio says to but listen if they tell you back off!

Cheers!

[Carmellow26]

Hello all,

4 weeks ago from today I tripped on stairs and fractured my ankle- NONDISPLACED lateral malleolus fracture- the day I did it I went to the ER and they took xrays and put a splint on me for a few days so the swelling would go down. I went and saw and Orthopedic Doctor that day and he told me to come back in 3 days to get a hard cast put on. I went back and got the hard cast put on and it was left on for 3 weeks. Last friday (Apr 13) I got it removed and got another xray. The Orthopedic Doctor told me that it is healing good and told me to wear a Walking Boot for a month and do at home exercises with my foot and then come back in to see him and get another xray.

Well here is where I need your help....I have the walking boot and have been trying since I got my cast off 5 days ago to walk with the walking boot....but I just cant seem to! I dont know if its mental or what but it hurts a little when I try to. I have been using crutches and trying to put some pressure on it which is fine, but when I try and just use one crutch and put weight on it it hurts and to me it feels like the bone is just going to crack.....is this possible after 4 weeks for it to break again while walking in the boot? or is it all in my head? I want to do it so so badly but just cant seem to. The only exercise I have been able to do since the hard cast came off is move my foot up and down, I am too scared to rotate my ankle in a circular motion =/ is there any other type of exercises you would reccomend for at home? And back to the boot....what is the easiest and least painful way to do this? Does it usually take a week or 2 to be able to walk with the boot alone and no crutches? Or am I just being a baby? My mom thinks I should be able to and is getting frustrated with me and thinks I am a baby for not being able to walk on it completely without crutches....I tell her she doesnt know how it feels. Is it normal for it to hurt the first week or so? I put a sock on and the boot itself is not uncomfortable, its my actual ankle area where I fractured it...I can like feel the bone aching when I put weight on it and in my mind I feel like I will make it worse by walking, but then again the Doctor said its healing nicely and I can put all my weight on it.


Any suggestions or advice?